Reduced serum Sestrin-1 is associated with subclinical cardiovascular alterations in systemic lupus erythematosus: A...

ObjectiveSystemic lupus erythematosus is associated with increased cardiovascular morbidity, even in the absence of overt clinical disease. Sestrin-1 is a stress-responsive antioxidant protein implicated in oxidative homeostasis and cardiovascular protection. This study aimed to evaluate serum Sestrin-1 levels in patients with systemic lupus erythematosus and examine their relationship with subclinical cardiovascular findings.MethodsIn this controlled cross-sectional study, 60 patients with systemic lupus erythematosus and 60 age-matched healthy controls underwent clinical assessment, laboratory testing, 12-lead electrocardiography, transthoracic echocardiography, and carotid intima-media thickness measurement. Serum Sestrin-1 was measured by enzyme-linked immunosorbent assay (ELISA). Between-group comparisons used parametric or nonparametric tests according to data distribution. Within the systemic lupus erythematosus cohort, correlations between Sestrin-1 and disease activity (Systemic Lupus Erythematosus Disease Activity Index), as well as cardiovascular parameters, were assessed. An exploratory multivariable logistic regression model including Sestrin-1, left atrial diameter, corrected QT interval, age, and sex was constructed to identify variables associated with case status.ResultsSerum Sestrin-1 levels were significantly lower in patients with systemic lupus erythematosus than in controls (9.99 ± 2.01 vs. 17.79 ± 5.11 ng/mL; p < 0.001). Patients with systemic lupus erythematosus had a significantly longer corrected QT interval (429.65 ± 32.42 vs. 376.26 ± 33.41 ms; p < 0.001). In the exploratory multivariable logistic regression analysis, lower Sestrin-1 (per 1ng/mL increase, odds ratio 0.63; 95% confidence interval: 0.54-0.75; p < 0.001), larger left atrial diameter (per 1 mm increase, odds ratio 1.13; 95% confidence interval: 1.06-1.22; p < 0.001)), and longer corrected QT interval (per 1ms increase, odds ratio 1.03; 95% confidence interval: 1.02-1.05; p < 0.001) were independently associated with systemic lupus erythematosus status.ConclusionPatients with systemic lupus erythematosus exhibit markedly reduced serum Sestrin-1 levels together with subclinical cardiovascular abnormalities. The inverse relationship between Sestrin-1 and left atrial diameter suggests a possible link between reduced antioxidant defense and early atrial remodeling in systemic lupus erythematosus. Sestrin-1 may represent a promising candidate biomarker for subclinical cardiovascular involvement in patients with systemic lupus erythematosus; however, prospective studies are needed to confirm its clinical utility.